| NPI | 1174615678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC005408) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NJ 37PC00341800) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2008-12-10 |